Fem. The ''abortion'' pill now in France

219/474  16  Apr 90 01:28:00
From: Robert Hood
RU486
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The
following consists of excerpts from an article that concerns
the controversial RU 486 "abortion  pill".    This  article,
"Profiles  in Courage: Dr. E. E. Baulieu" appears in the May
1990 issue of Penthouse Forum and starts on page 40.  (Okay,
so   it   ain't   exactly  Newsweek....)  These  quotes  are
restricted to the discussion of RU 486, and do  not  include
the discussion of Dr.  Baulieu that can also be found in the
article.   Quotes  from  different  parts of the article are
separated by blank lines,  and  boldfaced  subheadings  have
been converted to CAPS.
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   In  the  early  seventies,  Baulieu and his research team
discovered the receptors within the cells of the uterus that
receive messages from progestrone.  This led them to  search
for  a  chemical  that  poses  as  a  progestrone  impostor,
tricking the uterus into rejecting  the  real  thing.    The
concept  is  the next step beyond conventional birth-control
pills, which fool the body  into  behaving  as  if  it  were
already pregnant   and  thus  prevent  fertilization.    The
progestrone impostor tricks the body into behaving as if the
lining of the uterus were already receiving the  progestrone
necessary  for  the  development  of  a fertilized egg, thus
rejecting the true hormone.

   THE MONTH-AFTER PILL to be.    As  approved  for  use  in
France  (in  1986),  it  must  be  used within five weeks of
conception - the time period in which it is safest and  most
effective.

   Usually,  RU 486 is prescribed within days after a missed
period.  French women are  not  permitted  to  take  it  the
morning  after  coitus  and  possible  conception;  they are
required to take a pregnancy test and then - if  pregnant  -
to wait  a  week  in  order to be sure of their decision.  A
dosage    of    six    hundred    milligrams    in     three
two-hundred-milligram pills is ninety-five percent effective
when followed by a shot of prostaglandin, a drug that causes
uterine contractions,  two  days  later.    Women report the
effects are like a heavy period, with  accompanying  cramps,
lasting several days.

      RU  486,  a  synthetic  steroid,  generically known as
mifepristone, is [...] chemically different, yet  remarkably
similar to  progesterone  and  [blocks] its action.  Without
progesterone, the lining of the uterine wall breaks down and
is sloughed off, causing menstruation.

      Over ten thousand women have received RU 486 abortions
in France, where it is available only in designated  clinics
and hospitals.    At  a cost equivalent to about one hundred
and twenty-five  dollars,  the  procedure  is  cheaper  than
surgical abortion.   The risks of anesthesia, perforation of
the uterus during surgery, psychological  trauma,  infection
and infertility  are  avoided.  Other than the cramping and,
in some cases, nausea and fatigue, there have been  no  side
effects reported by French doctors.

      Critics,  however,  suggest RU 486 is not the harmless
drug its champions claim.  Most notably, Charlotte Low Allen
[...] has pointed to a number of possible drawbacks:

      o The process  is  time-consuming,  requiring  several
days  to  complete and three visits to a gynecologist rather
than one to the abortion clinic.

      o Heavy bleeding may occur in some women.

      o  A  woman   _might_   see   the   expelled   embryo,
approximately  three-quarters  of  an inch in length at that
stage of development.

      o Since long-term studies are not available, it  isn't
known if the drug can cause defects in subsequent fetuses or
suppress ovulation in some women.

      Obviously,   these   concerns   and  others  would  be
addressed  in  the  rigorus  testing  the  U.S.   government
requires of  all  drugs  before  allowing  their  use.   The
contragestation  pill  would  be  a  vast  improvement  over
surgical  abortion in developed countries, where deaths from
legal abortions are  relatively  rare.    In  underdeveloped
countries,  where clinical facilities are few and frequently
unsanitary by Western standards, the pill might save most of
the  hundred  thousand   lives   lost   worldwide   to   the
complications of  abortions  each  year.  China [...] is the
only nation that will get RU 486 in  the  immediate  future.
Sweden  and  the  United  Kingdom will probably soon follow.
Yet the prospects for research and eventual distribution  of
the  pill  in  the  United  States  in the forseeable future
aren't good.

   THE POLITICS OF ABORTION

      Labeling it the "French death pill," militant pro-life
forces regard RU 486 as the most  serious  threat  to  their
cause since  abortions  were made legal.  But while pro-life
activists operate on the belief that conception is  achieved
with fertilization, the American College of Obstetricians an
Gynecologists  defines  conception  as  _implantation_  of a
fertilized egg, not merely fertilization (a large percentage
of fertilized eggs fail naturally  to  implant  themselves).
Thus   RU  486  could  be  labeled  in  this  country  as  a
contraceptive, not an abortifacient.  However it is labeled,
the pill, pro-life forces fear, would be treated by many  as
a menstrual inducer, thus psychologically skirting the issue
of abortion. "We'd lose some of our best arguments," Richard
Glasgow,  education  director  of the National Right to Life
Committee has admitted, possibly referring to  the  pictures
of  tiny mutilated fetuses that pro-life advocates sometimes
wave in the  faces  of  women  entering  clinics.    Perhaps
clinics would  no  longer  be necessary for most women.  The
matter would become a more private  one,  involving  only  a
woman  and  her  gynecologist - making it far more difficult
for pro-lifers to mount their terrorist tactics.

   [Description of  U.S.  pro-lifers'  intended  boycott  of
Hoeschst AG omitted.]

      Drug  experts  point out that no other proven drug has
ever been  withheld  in  this  manner.      The   power   of
anti-abortion   activists,   particularly   in  America,  is
awesome.  Though they represent  a  minority  opinion,  they
have, until very recently, been successful in imposing their
viewpoint on  the  rest of the country.  Packing the Supreme
Court with right-wing pro-life justices was  only  the  most
visible of their moves.  In addition they have:

      o   Stopped   the   use  of  federal  funds  to  study
abortifacients.

      o Reduced the number of U.S. pharmaceutical  companies
that  have research programs to study human reproduction and
contraception from twenty in 1970 to _one_ -  namely,  Ortho
Pharmaceutical Corporation.

      o  Confined  the  distribution of RU 486 to France and
China.

   [Description and  examples  of  the  pro-life  boycotting
tactics omitted.]

      Their efforts may lead to black-market smuggling of RU
486.  Experts fear the drug will be misused if this happens.
The follow-up injection (or, sometimes, vaginal suppository)
of prostaglandin  is  an  essential part of the process.  If
the drug is taken more than eight weeks after conception, or
without  the  additional  hormone  -  and  without  adequate
medical  supervision  -  excessive bleeding or an incomplete
abortion may result.  The only way to prevent a black-market
trade in RU 486 is to make  illicit  sales  unprofitable  by
supplying it legally in all the countries of the world.

   RU 486 IN AMERICA

      [...]  no U.S. companies have applied for a license to
bring the drug here.

   If that were  done,  the  testing  period  for  full  FDA
approval would take another twenty months to two years.

      [...]   One  possible  candidate  is  GynoPharma,  the
Summerville,  New  Jersey  firm  that  manufactures  an  IUD
developed by  the  Population  Council.    According  to  an
article in _Business Week_ magazine, "The company denies it,
but sources at Roussel confirm that it has held  talks  with
GynoPharma."

      Perhaps  the  changing  political  climate in the U.S.
will encourage GynoPharma or some other small firm to  apply
for a   license.     The  pro-choice  rallies  organized  in
Washington D.C. in April and November of  1989  were  larger
than  any  pro-life  march  on  the  capital  has ever seen.
Government may finally  be  getting  the  message  that  the
majority  of  Americans  are  pro-choice, as they repeatedly
tell poll-takers.  Many are also angered and appalled at how
the minority has so far succeeded in banning RU 486.

      Baulieu [...] uses the media to spread the facts about
the drug  and  the  politics  behind  its  exceedingly  slow
acceptance around the world.  Lest one think he is motivated
by  the desire for money, Baulieu does not collect royalties
from sales of the pill.

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   I will not reply directly to this article's points except
to say that I promote the rights of the individual to choose
for him/herself in most issues, abortion being only  one  of
them.  If RU 486 is a safe alternative to surgical abortion,
I  believe  the  United States should at least start testing
it, and hopefully distribute it.  I agree  with  the  French
system  that  puts  this  medication in a doctor's hands and
does not distribute it as just another birth  control  pill,
and  believe that RU 486 should be offered as an alternative
to surgical abortion (perhaps even in the abortion clinics).


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